century England: "That disease .. was
then the most terrible of all the ministers of
death.... smallpox was always present,
filling the churchyards with corpses . . and
making the eyes and cheeks of the betrothed
maiden objects of horror to the lover."
In 1796 English country physician Ed
ward Jenner showed that a mild infection
acquired from cows, called cowpox, gave
immunity from smallpox. Material taken
from a cowpox pustule could
be used to protect others.
Within years, cowpox vac
cine was being distributed
around the world. Yet, until
the present century, prob
lems in producing and pre
serving vaccine precluded
more than partial control.
Not until the 1940's were
Europe and North America
rid of smallpox. In develop
ing countries it remained epi
demic, and cases were often
exported into smallpox-free
areas. Health officials feared
it as no other disease. In all
countries vaccination pro
grams continued, and quar
antine inspectors tried to
enforce the international
edict that all travelers be
vaccinated.
In 1959 an initial attempt
by WHO to eradicate small
pox was begun, but the effort
failed. Most countries had
too few resources, and WHO
could offer little help.
I had been working on a
were understandable. Smallpox moved
readily across open borders. It seemed un
reasonable to expect that programs could be
orchestrated in fifty affected countries, in
cluding the world's least developed, many
with large, remote areas and populations
that had never seen a health worker.
Shortly I was surprised by a call from
WHO's director-general, who asked me to
head the campaign. I was hesitant, and my
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measles-smallpox program
for 18 West African nations, sponsored by
the Agency for International Development
and the Center for Disease Control in Atlan
ta. I was learning firsthand in seven-day
weeks the problems of planning, logistics,
and personnel. Then in May 1966 WHO
was authorized to begin a global smallpox
eradication campaign.
The goal was to stamp out smallpox with
in ten years. As I was to learn, few believed
that smallpox, or any other disease, could
really be eliminated. Malaria and yellow
fever eradication had failed. Reservations
798
Front lines in a global battle
shifted to some of the world's
most hostile terrain as smallpox
was tracked to its final outposts.
In the Ogaden region of the
Horn of Africa, disputed by
Ethiopia and Somalia, a health
officer questions a nomad wom
an (right). Despite civil unrest,
scattered populations, and frac
tured terrain, smallpox was ex
tinguished here in 1976.
The campaign's international
scope is reflected in stamps is
sued by (left, from top) the Unit
ed Nations, Guinea, and Egypt,
among many others.
Mounted from the Geneva
headquarters of the World
Health Organization (WHO),
the eradication campaign en
listed specialists from around
the world, physicians and ad
ministrators from countries af
fected, paramedical personnel,
and thousands of volunteers,
such as teachers and Boy
Scouts, trained in the field.
doubts were confirmed by a respected col
league, who said: "If you think you have
problems now in coping with bureaucracy,
multiply the problems by the number of UN
countries. You don't stand a chance."
Convinced that it would be a waste of
time, I so informed the surgeon general of
the U. S. Public Health Service, my superior
then. He, in turn, informed me that I was
ordered to go-for at least nine months. Re
luctantly my wife and I stored our furniture
and left with our children for Geneva, Swit
zerland, WHO (Continued on page 803)
NationalGeographic,December 1978